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ANTIMICROBIAL RESISTANCE
Antibiotics: the good news and the bad
Although the European Centre for Disease Prevention and Control has issued a warning that the last line of antibiotics is failing, there are encouraging signs that antibiotic stewardship is improving – healthcare and veterinary professionals are reported to be making positive changes in prescribing practice.
Antimicrobial resistance (AMR) has become one of the biggest threats to global health – without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery will become very high risk. In addition, there is growing concern that the last line of antibiotics are failing for some pathogens.
On the 9th European Antibiotic Awareness
Day, the European Centre for Disease Prevention and Control (ECDC) released its latest EU-wide data on antibiotic resistance and antibiotic consumption. In 2015, antibiotic resistance continued to increase for most bacteria and antibiotics under surveillance. In particular, the EU average percentage of carbapenem resistance in Klebsiella pneumoniae increased from 6.2% in 2012 to 8.1% in 2015, and combined resistance to carbapenems and polymyxins (e.g. colistin) was sometimes reported. These two groups of antibiotics are considered last-line antibiotics as they usually are the last treatment options for patients infected with bacteria resistant to other available antibiotics. While antibiotic consumption in hospitals significantly increased in several EU Member States, antibiotic consumption in the community decreased in six EU Member States. Vytenis Andriukaitis, European Commissioner for Health and Food Safety, said: “Antibiotic resistance is one of the most pressing public health issues of our time. If we don’t tackle it, we can go back to a time when even the simplest medical operations were not possible, and organ transplants, cancer chemotherapy or intensive care even less so.” He added: “The European Commission will launch a new Action Plan in 2017 so that we can, together with our partners in the EU Member States and internationally, continue to ensure that the prevention and control of antibiotic resistance is strengthened within a one-health approach.”
FEBRUARY 2017
ECDC acting director, Dr Andrea Ammon,
said: “Antibiotic resistance in Klebsiella pneumoniae is of increasing concern in Europe. More than one third of the isolates reported to ECDC for 2015 were resistant to at least one of the antibiotic groups under surveillance, and combined resistance to multiple antibiotic groups was common. Moreover, the emergence of K. pneumoniae infections with combined resistance to carbapenems and colistin is worrisome and an important warning that options for treatment are now even more limited than in the past.” ECDC’s data also show that antibiotic resistance in Escherichia coli, one of the most frequent causes of bloodstream infections and community- and healthcare-associated urinary tract infections, requires close attention as the percentages of isolates resistant to commonly used antibiotics continues to increase throughout Europe. In contrast, the percentage of meticillin-resistant Staphylococcus aureus (MRSA) showed a significantly decreasing trend at EU/EEA level between 2012 and 2015. Despite this
positive development, MRSA remains a public health priority as eight out of thirty countries reported percentages above 25%. Dr Zsuzsanna Jakab, WHO regional director for Europe, said: “Surveillance of antibiotic resistance is the backbone of our work in defence of antibiotics’ effectiveness. Until we know where resistance is, we cannot prioritise action. This is why we focus on expanding the map of antibiotic resistance beyond the European Union countries through the Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) network. “What the report indicates is of concern: our patients are exposed to resistant bacteria in hospitals due to overuse and misuse of antibiotics and poor infection prevention and control. We urge our leaders to use this evidence and accelerate their response to a major global health threat of our time.”
Antibiotic resistance and gonococci
While resistance increased in some pathogens, the ECDC reported some encouraging news regarding sexually transmitted infection.
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